Levoscoliosis: A Comprehensive Guide to Symptoms, Causes, and Treatment

Levoscoliosis is a specific type of scoliosis where the spine curves abnormally to the left. While scoliosis affects an estimated 7 million people in the United States, understanding the direction of the curve is crucial for diagnosis and treatment. Unlike the more common rightward curve, a left-sided curve can sometimes be a signal of an underlying health issue.

This comprehensive guide synthesizes medical expertise to cover the symptoms, causes, diagnosis, and full range of treatment options for levoscoliosis, helping you navigate this condition with clarity.

What is Levoscoliosis?

Levoscoliosis is defined as a sideways curvature of the spine that bends to the left, often forming a "C" shape. It most commonly occurs in the lumbar (lower back) region but can also affect the thoracic (middle) spine.

It's important to distinguish levoscoliosis from its counterpart:

• Levoscoliosis: The spine curves to the left.
• Dextroscoliosis: The spine curves to the right.

Sometimes, the spine can have two curves, creating an "S" shape. This may involve both levoscoliosis and dextroscoliosis in different sections of the spine.

An illustration showing the difference between a normal spine and a spine with levoscoliosis. Source: Jeremy Smith, MD

Why Levoscoliosis is Considered 'Atypical'

In about 80% of scoliosis cases, the cause is unknown (idiopathic), and the curve typically bends to the right. For this reason, doctors consider a left-bending curve—levoscoliosis—to be "atypical." Its presence is often seen as a red flag that warrants a deeper investigation to rule out an underlying cause.

Symptoms of Levoscoliosis

Symptoms vary greatly depending on the severity of the curve. Mild cases, especially in children and adolescents, may have no noticeable symptoms other than physical changes.

Common Visual Signs:

• Uneven shoulders, with one appearing higher than the other.
• An uneven waist or hips.
• One shoulder blade that protrudes more than the other.
• A "rib hump," where ribs on one side stick out further, especially when bending forward.
• Clothes that hang unevenly on the body.
• The head appearing off-center with the rest of the body.

Symptoms of More Severe Curves:

• Back pain and stiffness.
• Fatigue, especially after long periods of sitting or standing.
• Nerve-related symptoms like pain, numbness, or weakness that radiates into the legs.
• Shortness of breath or chest pain if a severe thoracic curve restricts lung space.
• In rare, severe cases, loss of bladder or bowel control due to nerve compression.

Causes and Risk Factors

While the majority of scoliosis cases are idiopathic, levoscoliosis is more frequently linked to specific causes.

• Idiopathic Scoliosis: The most common type, with no identifiable cause. It typically appears in children between age 10 and puberty.
• Congenital Scoliosis: Caused by a malformation of one or more vertebrae during fetal development. This condition is present at birth.
• Neuromuscular Scoliosis: Results from conditions that affect the nerves and muscles supporting the spine, such as cerebral palsy, muscular dystrophy, or spina bifida.
• Degenerative Scoliosis: Occurs in adults due to the age-related wear and tear of spinal discs and joints.
• Traumatic Scoliosis: Caused by an injury, fracture, or tumor affecting the spine.

Key Risk Factors

• Age: Scoliosis most often develops during the growth spurt just before puberty.
• Sex: While mild scoliosis occurs at similar rates in all sexes, girls are eight times more likely to develop curves severe enough to require treatment.
• Family History: About 30% of adolescents with idiopathic scoliosis have a family history of the condition, suggesting a genetic link.

How Levoscoliosis is Diagnosed

Diagnosing levoscoliosis involves a physical examination and imaging tests.

1. Physical Examination: A doctor will assess posture, checking for asymmetry in the shoulders, waist, and hips. The Adam's Forward Bend Test is a common screening tool where the patient bends at the waist, allowing the doctor to view the spine from behind to check for a rib hump or abnormal curvature.
2. Imaging Tests:
   • X-ray: This is the primary diagnostic tool. An X-ray confirms the presence of a curve and allows for precise measurement.
   • Cobb Angle: Doctors use the X-ray to measure the Cobb angle, which quantifies the degree of curvature. A curve is generally considered scoliosis if the Cobb angle is 10 degrees or more.
   • MRI and CT Scans: If a doctor suspects an underlying cause, such as a tumor or spinal cord abnormality, an MRI or CT scan may be ordered to get a more detailed view of the spine and surrounding tissues.

Treatment for Levoscoliosis

Treatment plans are tailored to the individual and depend on the patient's age, the severity and location of the curve, and the likelihood of progression.

Non-Surgical Treatments

For mild to moderate curves, the goal of non-surgical treatment is to prevent the curve from getting worse and to manage symptoms.

• Observation: For mild curves (10-25 degrees) in growing children, doctors often recommend a "watch and wait" approach, with follow-up X-rays every 6 months to monitor for progression.
• Bracing: In growing children with moderate curves (25-45 degrees), a custom-fitted plastic back brace can be highly effective at stopping the curve's progression. It does not correct the existing curve but can prevent the need for surgery. For adults, a brace may be used for short-term pain relief.
• Physical Therapy and Exercises: Scoliosis-specific exercises, such as the Schroth Method or the Scientific Exercise Approach to Scoliosis (SEAS), can help improve posture, strengthen core and back muscles, and reduce pain. Studies suggest these targeted exercises can improve trunk rotation and even help reduce the Cobb angle.
• Chiropractic Care: A chiropractor specializing in scoliosis may help improve flexibility and reduce pain. However, chiropractic adjustments cannot cure scoliosis.

Surgical Treatment

Surgery is typically reserved for severe curves (usually greater than 45-50 degrees) or curves that are progressing rapidly and causing significant symptoms.

The most common procedure is spinal fusion. In this surgery, an orthopedic surgeon straightens the spine with metal rods, hooks, and screws, and then uses bone grafts to fuse the affected vertebrae into a single, solid bone. This permanently corrects the curve and prevents further progression.

Long-Term Outlook and Prognosis

For the vast majority of people, levoscoliosis does not affect life expectancy, and they are able to lead full, active lives. The long-term prognosis is excellent for mild to moderate cases.

However, untreated severe scoliosis can lead to complications, including:

• Chronic Pain: Degenerative changes and uneven pressure on the spine can cause persistent pain in adulthood.
• Reduced Lung Function: A severe thoracic curve can restrict the rib cage's movement, impacting breathing capacity.
• Psychological Impact: Visible physical changes can affect body image and self-esteem, potentially leading to anxiety or depression.

Proactive treatment and management are key to preventing progression and ensuring a high quality of life. If you notice signs of scoliosis in yourself or your child, consulting a spine specialist for a proper diagnosis is the essential first step.

References

• American Association of Neurological Surgeons (AANS). (n.d.). Scoliosis.
• Cleveland Clinic. (2022). Levoscoliosis & Dextroscoliosis.
• Healthline. (2021). Levoscoliosis: Causes, Treatments, and More.
• Jeremy Smith, MD. (2025). Levoscoliosis vs. Dextroscoliosis of the Lumbar Spine.
• Mass General Brigham. (2025). How to Manage Adult Scoliosis.
• Medical News Today. (2020). Levoscoliosis: What it is, causes, and treatments.
• Total Ortho Sports Medicine. (n.d.). What is Levoscoliosis?
• Verywell Health. (2025). Levoscoliosis and Dextroscoliosis: An Overview.